22 months being referred to the paediatrician

[Firstimemum24]

Hi
Sorry for the long post but I feel lost at the moment and I’d like some help from fellow mums and dads .
help me with my little
My little one 22 months DD

1. answer to questions with yes but not with no . When she doesn’t want something she doesn’t answer
2. Answer to where’s and what’s and who’s questions with familiar faces
3. Give kisses and high five
4. Point , wave and clap
5. Ask for what she wants by pointing or using the word for it and asks for help
6. Follow simple instructions such as : “ bring mum the fork “ pick it up and give it mummy “ come here and stop and wait for mom “ when outside . Sit on the couch , bath time and food time she sits on her little chair , put bunny to bed or bring me the blanket, let’s change . But that’s it she is not improving on that front
7. Uses over 200 words and sometimes 2 word phrases : like feed baby , daddy train , spin me , more crackers please , wash bunny ,
8. She loves playing in front of the mirror and copying some songs and play hide and seek with us
9. She loves cuddles
10. She enjoys sitting and reading a book and point at what she sees
11. She can point to every body parts
12. Says hi to people and kids
13. She doesn’t have meltdowns that go on

Concerns

1. toe walker ( I have been told it is a milestone 🤔) since she was 14 months
2. Very shy and anxious around people and doesn’t like playgroups but then again she is an only child
3. Picky eater ( this is what she eats ) bolognese pasta
4. Pasta with ricotta and tomato
5. Pasta pesto
6. Pasta with zucchine
7. Lasagna
8. Meatballs
9. Toast with butter and marmite
10. Almond and chocolate croissant
11. Banana and kiwi
12. Pear and peaches cantaloupe
13. Apples
14. Vegetarian sausage and peanut butter toast
15. Chicken and Brie sandwich
16. Raw Carrots and. Broccoli
17. Veggies crisps

She doesn’t seem to be able to sit still when she has dinner and she is most happiest when it is just us 3 and no family in the house . She starts to whine when other people are around or gets overexcited . The thing is not was ever able to get close to her since she was born because of her personality.
We don’t take her to lunches or coffee shops as she would sit in the buggy

She passes the Mchat with 0 and the ASQ questionnaire for 24 months but she has been referred to see a paediatrician due to social anxiety ( mostly just as a precaution the HV said ) .
I am so confused and lost because we never had anyone on the spectrum on both sides of the family and I am trying to learn everything that I can . Research shows that when not genetic it is environmental but I haven’t been exposed to anything different

What instructions can a 22 months old follow ? ☺️

I get that you're anxious about this, OP, but you've posted about the same thing at least 3 times now. I'm just not quite sure how this is helping?

Exactly this

22 months isn't 2 years

@Firstimemum24 you really need to get help for your anxiety as it's clearly holding your DD back and causing you to fixate over and pathologise what sounds like normal development.

Are you getting help for your anxiety?

Remember you don't need to consent to further paediatrician assessment if you don't want to or don't feel ready. It does sound as if your Health Visitor may be querying autism for your DH, however this doesn't qualify as a health "problem" necessarily if you are tuning in to her personality, needs and communication and supporting them. Girls with an autism profile can be very subtle, so please don't discount the possibility too quickly. Things are to tune in to:

• How does she communicate and for what purpose? Perhaps she can use language at home with her parents but finds this harder in other settings. How does she initiate interactions? Does she echo language without understanding it sometimes?

-- Nonverbal communication : Does she use eye contact typically (which involves coordinating it with other communication modes). Does she use variable facial expression or is it quite neutral? Does she exchange social smiles? -How does she understand and process information? Does she have a need for predictability and feels anxious when she doesn't know the plan or it changes? Does she need extra time to process info? Does she need time to shift attention from one thing to another?

• Interactions with peers: other children are much less predictable than adults. She may need support to understand the 'invisible social rules'. And equally, other children may need support to understand how she sees the world.

-Play and interaction: Is she able to be flexible? Some children need support to learn how to allow others to enter their play, and to cope with the 'give and take' that interactive play involves. -Sensory: How is she with visual stimuli? Does she enjoy sorting and organising objects (and could be upset if they are all mixed up?). How is she with mess, eg on her hands? Sounds and smells: does she notice these more and become distracted or dysregulated by them? Does she like deep pressure or enclosed spaces that make her feel safe? Emotioal regulation : Is she easily upset, or very insistent on having her own way? Do you find yourself needing to work hard to keep things calm for her? Movement: Does she enjoy repetitive or certain types of movement. Eg rocking or spinning or running up and down. These may calm or excite her. Danger awarebess: Does she have awareness of risks (or what others don't want her to do), eh running into the road, climbing on top of high things.

None of these are terrible things, but if she is going to nursery or school in the future it may help if they understand her needs better so that they can support her. But it's OK to refuse further formal assessment if you wish to. You can still gather and share the type of information above. I will say however that waiting lists are long so you might wish to just keep your place one while you take time to reflect. If your daughter is autistic, it sounds like she is happy and thriving, which is brilliant. I'm sorry this is a difficult stage for you. It is hard to think about our children being on a slightly (or majorly) different pathway. Good luck!

She sounds very typical of a nearly 2 year old to me. That list of foods qualifies her as an excellent eater and not a picky eater in my experience. I don't see why she would need to be referred at this stage. It's normal for children to be shy, and her communication skills sound on point too.

I assume this is a private referral? If your worried get her checked out but fussy eating and toe walking ar pretty normal . The social anxiety is something to work on but she may just be shy.

Oops, I forgot a couple of things:

• Any obsessions or fixations?
• Any unusual unusual vocal patterns when she is speaking? Sing-song, exaggerated or monotone?

Anyway, don't let anybody tell you you should stop being anxious. There may be a reason you are anxious about your daughter's development, and it's often sensible to consider autism as it is very common. It is possible to see signs at 22 months. It's about channelling your concerns in the right direction and understanding your daughter as best you can. You are doing that. I hope you can start to feel confident that you are doing a great job.

It seems very cautious to make a referral and surprising given limited nhs resources. Girls present autism differently to boys, are often diagnosed later as a result, and nothing you list would raise alarm bells at 22 months. Kids go through phases regarding food , texture and flavour preferences vary during teething etc and to explore.

Probably because OP is worrying.

You don’t get referrals bases on a parental concern. Especially when taken the op at their word there’s nothin in that op that would warrant a referral.

I’m so confused. Your child is exactly the same as every other child the same age - there is no concern here.

Don’t let your anxiety screw with your kids.

You don’t get referrals bases on a parental concern. Especially when taken the op at their word there’s nothin in that op that would warrant a referral

God I wished you did sometimes. DD would have been referred 12 years earlier in our case.

You say picky eater but list a large number of things she will eat? Where is the picky part..? My DS1 wouldnt touch anything with sauce/gravy or any form of potato. Now at 13YO still eats a dry roast with no tatties! DS2 could not put broccoli or chicken in his mouth because of the fibrous texture. When trying to encourage him he would gag as soon as they touched his mouth and once spewed on his own plate. DS2 now 11, can do chicken but not broccoli. Neither will touch any food in mash form.

Just examples, there are countless more. When you say someone is picky I think it’s important to list what they can’t eat?

It sounds like she has been referred more for her social anxiety? Sometimes anxiety is that, and it doesn’t automatically mean she is on the spectrum.

I do wish parental input was taken more seriously. Some medics don’t listen when they really should.

@Firstimemum24
Your concerns:

1 - toe walker. My dd did that, and ended up a professional ballet dancer. Nothing to worry about.

2 - shy and anxious and all the rest. So are loads of other toddlers. Nothing to worry about.

3 etc - food. She eats a considerably more varied group of foods than my dd did at that age. Nothing to worry about.

There is absolutely nothing wrong with your child.

Just wanted to say that I still toe walk at age 37 and I always have, I am not Nero diverse (very sociable person). I was also a very picky eater as a child but eat well as an adult.

For what it's worth I think her diet sounds very diverse and varied to what many autistic children might eat x

Where I live (in the UK) you do indeed get referrals on parental concern. It is considered a valid reason.

I am not Nero diverse (very sociable person).

What an odd statement. Do you think that some people with ASD aren't friendly or extroverts?

Hi everyone
yes she has good diet but doesn’t eat enough of food on a daily basis . She is healthy and strong though . My biggest fear I guess is that I don’t know how I can help her socially . We tried playgroups , church groups and toddler groups but we had to put a stop to it as she was quite anxious and even waiting in line for the doors to open caused a scene . We don’t have family over and we rarely see grandparents because she won’t get close ever

You’re not helping but not going to places, all that is doing is reinforcing her anxieties. She doesn’t need to get close to people but she does need to be around them.

as for the food - if she is gaining weight and staying healthy then she is getting enough for her needs. I think many of us have lost sight of what is a proper portion and tend to head towards overfeeding.

So did you not think of turning up 5 minutes after the doors open so you could go straight in? Or finding quieter more structured groups that might suit her better?

No wonder she is socially anxious, listening to how anxious you are!

If she eats a varied diet and is "healthy and strong" then what exactly is the concern? I'm not seeing the problem?

Jesus OP you need to stop posting this. Look back at the other threads you’ve posted and everyone tells you the same.

As for social anxiety at 22 months I feel like I’ve heard it all now. Avoiding social situations isn’t going to help though.

The main concern is when she is also with familiar people , like family or grandparents she has never got close to them to show them toys or for a cuddle. This what prompted the HV to make a referral.

How often does she see them? How familiar are they to her?

Some toddlers just don't like cuddling people they don't know very well - most adults don't either so I don't know why we expect it of small children tbh!